Sprained Ankle Rehabilitation
By Matt Paulus, Certified Athletic Trainer
Rehabilitation for Sprained Ankles
The rehabilitation procedures for a sprained ankle include immediate treatment, stretching to increase ROM, conditioning, total body fitness, training, and the use of heat and cold. A sprained ankle can come in any of the three classifications for a sprain (levels 1,2 and 3). To learn more from JOI Rehab, please read Ankle Sprains.
Image of woman with a sprained ankle.
Immediate Treatment of a Sprained Ankle
The immediate treatment for a sprained ankle is RICER. This acronym stands for:
- R: Rest.
- I: Ice. Place ice on the sprain for 20 min every 2 hours for 48 hrs.
- C: Compression. Fit the ankle with a compression bandage.
- E: Elevation. Make sure the ankle is above the heart when elevating.
- R: Referral. The athlete should be referred to a medical or health professional to have the ankle formally assessed. To learn more about treatment, please go to RICE Protocol.
Stretching and Increased ROM
There are many muscles around the ankle joint including the gastrocnemius, soleus, and tibialis anterior. Athlete’s suffering an injury to their ankle will begin rehabilitation through slow isometric stretches of the many muscles around the joint. Pain should be minimal during this period, as stretching too far can cause re-injury of the ligament.
Conditioning
During the rehabilitation procedures for a sprained ankle, the athlete will need to begin to condition the muscles around the ankle to strengthen the joint. Often with a sprained ankle, some muscles are strained, which means conditioning should begin with light activities and progress. Conditioning exercises can be as simple as inversion and eversion movements of the ankle, as well as plantar and dorsiflexion. Conditioning will progress to becoming weight bearing, jogging, running, and then changing direction and jumping at the end.
Total Body Fitness
During the rehabilitation procedures for a sprained ankle, the athlete will want to maintain total body fitness, and will likely need to restore this post rehabilitation before competing again. Activities that can be done include, cycle ergometers and swimming as rehabilitation progresses, the athlete can begin to cycle before running etc as they recover. It will be important during this time for the athlete to also seek to maintain fitness through resistance training programs that decrease impact and force through the ankle. This can progress with recovery.
Training
Post-rehabilitation, the athlete will begin to resume normal training. To begin, the athlete may complete extra activities such as stretches to include in their warm up. They will also start with a lower intensity and build their skills etc back up as they are able. It is important that the athlete does not return to full training intensity too soon, as many athletes re-injure themselves in training just prior to a return to competition. For a sprained ankle, agility and jumping activities should be limited until strength, balance and stability are regained.
Throughout the rehabilitation procedures for a sprained ankle, the athlete is likely to be required to tape and/or bandage their ankle to help provide support, restrict movement, add stability, and reduce swelling.
Use of Heat and Cold
Ice is often used throughout rehabilitation procedures for a sprained ankle. It is especially during the immediate treatment and during the beginning stages of rehabilitation after treatment. This is to help reduce inflammation around the joint and allow for greater range of motion. Heat can be used to help warm the ankle and allow for greater range of motion during the rehabilitation procedure or specific treatments. Often hydrotherapy is used to help reduce the force through the ankle, but also to provide heat to the area. Heat increases blood supply and helps the body to rebuild the tissue. We do not recommend heat during the first week to 2 weeks of treatment.
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